[Acute thoracic pain].

We report the case of a 56 year-old female patient without previous medical history presenting in the emergency room with acute left-sided thoracic pain and dyspnea. Initial lab exams, ECG and chest X-ray in supine position were normal and excluded most common pathologies, e.g. a large pneumothorax or myocardial infarction. A subsequent computed tomography to exclude an aortic dissection or pulmonary embolism showed left-sided sero-pneumothorax and mediastinal air. A spontaneous esophageal rupture (Boerhaave Syndrome) was diagnosed. An additional fluoroscopic study was performed to evaluate the exact site of rupture.